A girl, who was injured by what activists said was shelling by forces loyal to Syria's President Bashar al-Assad, stands at the entrance of her house in the Douma neighborhood of Damascus, Syria, November 22, 2015.
Bassam Khabieh / Reuters

Conducting humanitarian operations in war zones is inevitably challenging. Delivery of effective aid demands adherence to the four key humanitarian principles laid out by the International Federation of Red Cross and Red Crescent Societies in 1965. The first two, humanity (alleviating suffering) and impartiality (prioritizing those in greatest need), are ethical principles that make the difference between merely doling out charity and providing humanitarian relief. The second two, neutrality (not taking sides) and independence (from the government), are pragmatic principles for operating in conflict settings. In combination with international humanitarian law governing the conduct of warring parties, which affirms the right to give and receive assistance, the four principles generate the humanitarian space required to operate in war zones.

Providing humanitarian relief during civil wars (as opposed to international conflicts) is particularly difficult—perhaps never more so than during the war in Syria, where the government’s military strategy relies on

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  • ANNIE SPARROW, a critical care pediatrician and public health expert, is an Assistant Professor at the Arnhold Global Health Institute at the Icahn School of Medicine at Mount Sinai Hospital in New York City.
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